Category Archives: Respiratory

Tip 131: RDS 2

Respiratory distress syndrome (pulmonary surfactant deficiency) is seen almost exclusively in preterm infants, especially <34 weeks gestation. It is difficult to assess true incidence due to the use of prophylactic surfactant. Coding data from the Vermont Oxford Network for 2015 … Continue reading

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Tip 118: criteria for ECMO

The patient criteria for neonatal ECMO are: ≥ 35 weeks of gestation Weight ≥ 2Kg Severe hypoxic respiratory failure (OI >40 despite maximum conventional treatment, including high frequency oscillation, surfactant, nitric oxide) No irreversible organ dysfunction (e.g. severe HIE, major cardiac malformation) No … Continue reading

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Tip 115: indications for ECMO

Conditions which may require ECMO (extracorporeal membrane oxygenation) in the neonatal period include: Respiratory distress Syndrome (RDS) Meconium Aspiration Syndrome (MAS) Persistent Pulmonary Hypertension of the Newborn (PPHN) Sepsis, including pneumonia Congenital diaphragmatic hernia (CDH) Survival to home / discharge … Continue reading

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Tip 91b: congenital pulmonary adenomatous malformation (CPAM)

If hydrops is not present antenatally, spontaneous ‘resolution’ is common, with 50% of babies being asymptomatic at birth. Abnormal tissue may still be present, however, with later risk of malignant transformation. Hence these babies should have postnatal CT chest with … Continue reading

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Tip 60: pneumothorax

Pneumothorax is more frequent in the neonatal period than at any other time in life, significantly more so in infants <1500g. The risk for pneumothorax is increased in infants with: respiratory distress syndrome meconium aspiration syndrome pulmonary hypoplasia infants who … Continue reading

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Tip 50: surfactant for RDS

Using surfactant early (<2h age vs. late) in preterm infants with RDS requiring ventilation leads to reduced: pneumothorax (RR 0.69) pulmonary interstitial emphysema (RR 0.60) neonatal mortality (RR 0.84) chronic lung disease at 36 weeks’ gestation (RR 0.69). Reference: Bahadue, F.L., … Continue reading

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Tip 49: respiratory distress syndrome (RDS)

“For babies with RDS to have the best outcomes, it is essential that they have optimal supportive care, including: maintenance of normal body temperature proper fluid management good nutritional support appropriate management of the ductus arteriosus support of the circulation to … Continue reading

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